心脏术后病人内分泌变化及其临床意义

Changes of endocrine factors post cardiac surgery and its clinical significant

目的:探讨心脏术后病人血糖、血清甲状腺激素变化规律,其与疾病严重程度的关系及其临床意义。方法:选择的心脏术后病人根据是否发生多脏器功能障碍综合征(MODS)分为MODS和非MODS组,应用化学发光法测定52例病人入ICU后第1d及第2d血清甲状腺激素、促甲状腺激素(TSH)的含量,记录病人入ICU室的血糖值和急性生理及慢性健康评分II(APACHE-II)的分值。结果:两组病人血清游离T3(FT3)水平迅速下降(P<0.01),血糖水平明显升高,达(18.13±3.82)mmol/L;MODS组变化较非MODS组显著(P<0.05)。结论:(1)心脏术后病人发生高血糖,且与MODS相关;(2)心脏术后危重症病人血清甲状腺激素水平与病情的严重程度相关。

Objective：To investigate the changes of blood glucose and thyroid function occurring in patients after cardiac surgery and its clinical significant.Methods：A total of 52 patients after cardiac surgery with（21 cases）or without（31 cases）multiple organ dysfunction syndrome（MODS）were studied.Serum thyroid hormone and TSH concentrations were measured in 52 patients during intensive care unit（ICU）on first and third day by chemiluminescent immunoassay（CLIA）.Patients＇blood glucose and APACHE-Ⅱ score were recorded on first day during ICU.Results：Serum FT3 decreased（P〈0.05）and blood glucose increased markedly[（18.13±3.82）mmol/L] in 52 patients;Compared with non-MODS patients,above indaxes change were much more in MODS group.Conclusion：（1）Blood glucose significantly increase in patients after cardiac surgery and correlated with MODS;（2）APACHE-Ⅱ score is correlated with MODS.